Providing high-quality care for limited English proficient patients: The importance of language concordance and interpreter use
Providing high-quality care for limited English proficient patients: The importance of language concordance and interpreter use
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DOI：
10.1007/s11606-007-0340-z
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发表时间：
2007-11-01
影响因子：
5.7
通讯作者：
Kaplan, Sherrie H.
中科院分区：
文献类型：
--
作者：
Ngo-Metzger, Quyen;Sorkin, Dara H.;Kaplan, Sherrie H.
背景：提供者-患者语言不一致与讲西班牙语的英语能力有限（LEP）患者的护理质量较差有关。然而，鲜为人知的是语言障碍LEP Asian-American patients.Objective：我们研究了语言不一致的影响程度的健康教育和人际关系的护理质量，病人收到的，并检查其对病人满意度的影响。我们还评估了诊所口译员的存在/不存在如何影响这些结果。设计：横断面调查，应答率74%.Participants：共2，746名中国和越南患者在8个城市的I I卫生中心接受护理。测量：提供者-患者语言一致性，接受的健康教育，人际护理质量，患者对提供者的评分，以及诊所口译员的在场/缺席。回归分析用于调整潜在的confounding.Results：语言不一致的供应商的患者报告接受较少的健康教育（β =0.17，P < 0.05）相比，那些语言一致的供应商。使用诊所翻译器可减轻这种影响。语言不一致的提供者的患者也报告了更差的人际关系护理（β-0.28，p < 0.05），并且更可能给他们的提供者低评级（比值比[OR]=1.61; CI=0.97-2.67）。使用诊所翻译并没有减轻这些影响，实际上加剧了患者的看法provider.Conclusion：语言障碍与健康教育少，人际关系较差，病人满意度较低。有机会获得诊所翻译可以促进健康教育的传播。然而，就患者对其提供者的评价和人际护理的质量而言，有口译员在场并不能代替患者和提供者之间的语言一致性。
Background: Provider-patient language discordance is related to worse quality care for limited English proficient (LEP) patients who speak Spanish. However, little is known about language barriers among LEP Asian-American patients.Objective: We examined the effects of language discordance on the degree of health education and the quality of interpersonal care that patients received, and examined its effect on patient satisfaction. We also evaluated how the presence/absence of a clinic interpreter affected these outcomes.Design: Cross-sectional survey, response rate 74%.Participants: A total of 2,746 Chinese and Vietnamese patients receiving care at I I health centers in 8 cities.Measurements: Provider-patient language concordance, health education received, quality of interpersonal care, patient ratings of providers, and the presence/absence of a clinic interpreter. Regression analyses were used to adjust for potential confounding.Results: Patients with language-discordant providers reported receiving less health education (beta=0.17, p < 0.05) compared to those with language-concordant providers. This effect was mitigated with the use of a clinic interpreter. Patients with language-discordant providers also reported worse interpersonal care (beta-0.28, p < 0.05), and were more likely to give low ratings to their providers (odds ratio [OR]=1.61; CI=0.97-2.67). Using a clinic interpreter did not mitigate these effects and in fact exacerbated disparities in patients' perceptions of their providers.Conclusion: Language barriers are associated with less health education, worse interpersonal care, and lower patient satisfaction. Having access to a clinic interpreter can facilitate the transmission of health education. However, in terms of patients' ratings of their providers and the quality of interpersonal care, having an interpreter present does not serve as a substitute for language concordance between patient and provider.